In the 1990s, some districts in the Northern Vietnamese highlands were opened for international tourism. The development of tourism was expected to bring a new income source to remote mountain areas. This paper analyzes the association between tourism development, local livelihoods and land cover change at the household level. Sa Pa district was selected as a case study. In 25 rural villages within Sa Pa, 487 households were interviewed. This allowed us to classify rural households in three livelihood types: (1) full-time farming, (2) farming with limited involvement in tourism and (3) farming and major involvement in tourism activities. Next, the association between tourism and land cover change at the household level was quantified. The results show that the introduction of tourism increased the living standard of the ethnic minorities and led to more intensive farming systems with forest regrowth on abandoned fields. Nevertheless, the involvement in tourism is location dependent.